Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Home blood pressure telemonitoring improves hypertension control in general practice. The TeleBPCare study Gianfranco Parati a,b,c , Stefano Omboni d , Fabio Albini a , Lucia Piantoni a , Andrea Giuliano a,c , Miriam Revera a,c , Miklos Illyes e , Giuseppe Mancia a,b,c , on behalf of the TeleBPCare Study Group Background Self blood pressure monitoring at home may improve blood pressure control and patients’ compliance with treatment, but its implementation in daily practice faces difficulties. Teletransmission facilities may offer a more efficient approach to long-term home blood pressure monitoring. Methods Twelve general practitioners screened 391 consecutive uncontrolled mild–moderate hypertensive patients (80% treated), 329 of whom (58 W 11 years, 54% men) were randomized to either usual care on the basis of office blood pressure (group A, n U 113) or to integrated care on the basis of teletransmitted home blood pressure (group B, n U 216). Twenty-four-hour ambulatory blood pressure monitoring was performed at baseline and after 6 months, during which treatment was optimized according to either office (group A) or home (group B) blood pressure values. We compared differences between groups in the rate of daytime ambulatory blood pressure normalization (<130/80 mmHg), need of treatment changes during follow- up, quality of life scores, and healthcare costs. Results Baseline office blood pressures were 149 W 12/ 89 W 9 and 148 W 13/89 W 7 mmHg in groups A (n U 111) and B (n U 187) respectively, the corresponding daytime values being 140 W 11/84 W 8 and 139 W 11/84 W 8 mmHg. The percentage of daytime blood pressure normalization was higher in group B (62%) than in group A (50%) (P < 0.05). There were less frequent treatment changes in group B than in group A (9 vs. 14%, P < 0.05). Quality of life tended to be higher and costs lower in group B. Conclusion Patients’ management based on home blood pressure teletransmission led to a better control of ambulatory blood pressure than with usual care, with a more regular treatment regimen. J Hypertens 27:198–203 Q 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins. Journal of Hypertension 2009, 27:198–203 Keywords: ambulatory blood pressure monitoring, antihypertensive treatment, arterial hypertension, blood pressure control, home blood pressure monitoring, home blood pressure teletransmission, office blood pressure, patients’ compliance, quality of life, self blood pressure monitoring at home Abbreviations: ABP, Ambulatory Blood Pressure; DBP, Diastolic Blood Pressure; HBPM, Home Blood Pressure Monitoring; SBP, Systolic Blood Pressure a Department of Cardiology, San Luca Hospital, Istituto Auxologico Italiano, b Centro Interuniversitario di Fisiologia Clinica e Ipertensione, c Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan, d Italian Institute of Telemedicine, Varese, Italy and e Tensiomed Ltd, Budapest, Hungary Correspondence to Gianfranco Parati, MD, Department of Cardiology, San Luca Hospital, University of Milano-Bicocca and Istituto Auxologico Italiano, via Spagnoletto 3, Milan 20149, Italy Tel: +39 02 619112949/890; fax: +39 02 619112712/956; e-mail: gianfranco.parati@unimib.it Received 30 May 2008 Revised 11 August 2008 Accepted 21 August 2008 Introduction Self home blood pressure monitoring (HBPM) has a number of potential advantages in the management of hypertension [1]. These advantages include avoidance of the ‘white-coat effect’, availability of multiple BP read- ings over a wide time window, evaluation of the effects of treatment on BP at different times of the day, and improvement in patients’ adherence to therapy [1,2]. However, this approach also has potential drawbacks that can make its current implementation difficult in the clinical practice. These include the use of nonvalidated devices, need of patient’s training, the risk of patients becoming neurotically obsessed by the procedure, not infrequently with self-modifications of the prescribed antihypertensive treatment [3], and the possibility of an inaccurate report of home BP values by patients [4] as well as the difficulty for the physician to reach appro- priate diagnostic conclusions from evaluation of often badly hand-written patients’ BP reports. Indeed, it has been reported that in 54% of the cases, general prac- titioners (GPs) fail to draw any meaningful conclusion out of patients’ BP log books [5]. Progress in technology over the last few years has led to the availability of a number of systems for digital storage of HBPM data and for their teletransmission to remote sites [6]. Some observations have suggested that a com- bination of HBPM with teletransmission facilities may remove some of the inconveniences related to HBPM alone, allowing better clinical results to be achieved [7,8]. The aim of our study was to address this issue more specifically and to assess the impact of HBPM and data 198 Original article 0263-6352 ß 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins DOI:10.1097/HJH.0b013e3283163caf